The stakes are higher than you think. Perspectives on identity-first infrastructure and regulatory change.
The Stakes
Cybercrime, data breaches, fraud, and compliance failures cost the global economy more than $10 trillion annually. The root cause is not a lack of security tools — it is a broken architectural assumption that credentials and claims can stand in for proof. When everything can be faked, audit trails become forensically worthless.
Featured Perspectives
The 2025 NIST 800-63-4 federal identity assurance standard officially declared knowledge-based verification and voice recognition inadequate for high-assurance identity verification — citing AI vulnerabilities that make them trivial to defeat. Biometric liveness detection with cryptographic binding is now the mandated approach. Regulated organizations that haven't adapted are operating out of compliance today.
Industry consensus places Q-Day — the point at which quantum computers can break classical encryption — between 2028 and 2035. Migration to quantum-safe cryptography takes 5–8 years. Healthcare records must be retained for 50+ years. Financial records for 10–20 years. Classified government data for 75 years or more. The time to build quantum-safe infrastructure is now — not when the threat arrives.
Centralizing patient data to power AI creates regulatory exposure, sovereignty violations, and a single point of catastrophic failure. The alternative — bringing AI to where data lives, processing insights locally, and returning only results — is not a theoretical aspiration. It is a deployed reality, built on architecture battle-tested in classified U.S. defense and intelligence environments.
Use Cases
Electronic Visit Verification fraud costs U.S. Medicaid an estimated $5–8 billion annually. The root cause is simple: traditional EVV systems cannot prove that the right person was at the right place at the right time. Ekko's identity-first infrastructure makes fraud technically infeasible — not merely harder to commit — by cryptographically binding biometrically verified identity to precise geolocation data with tamper-proof timestamps. For a typical state Medicaid program, the ROI exceeds 10:1 in the first year.
Fifteen to twenty percent of all NEMT trips involve fraudulent activity — ghost rides, driver substitution, wrong passengers, route inflation — costing Medicaid more than $500 million annually. Ekko eliminates each fraud vector at the point of occurrence: if the patient's biometric scan doesn't happen at pickup and destination, the trip cannot be billed. Prevention, not detection.
America faces a quiet crisis: 30 million people are eligible for ongoing care management, and fewer than 2 million receive it — not because of a lack of will, but a lack of workforce. Ekko's identity-proofed communications backbone is powering a new generation of AI-enabled care delivery platforms operating in skilled nursing facilities today — ensuring that every clinical interaction is verified, every patient record is protected, and every data exchange stays within the walls of the organization that owns it.
Download
A detailed examination of the EVV fraud crisis, the vulnerabilities in current systems, and how Ekko's architecture eliminates entire categories of fraud while improving patient safety and reducing administrative burden.
An executive brief on the $500M+ NEMT fraud problem, the failure modes of current verification methods, and the financial case for cryptographic prevention over reactive investigation.